Endoprosthesis coating

ABSTRACT

A method includes: providing a tubular substrate in a chamber, the tubular substrate having a lumen, an a luminal surface and a luminal surface; providing a target in the lumen; depositing a first coating onto the abluminal surface and a second coating onto the luminal surface while keeping the tubular substrate in the chamber. An endoprosthesis, such as a stent, including a first coating on at least one portion of its abluminal surface and a second coating on at least one portion of its luminal surface is also disclosed.

TECHNICAL FIELD

This invention relates to medical devices, such as endoprostheses, and methods of making and using the same.

BACKGROUND

The body includes various passageways including blood vessels such as arteries, and other body lumens. These passageways sometimes become occluded or weakened. For example, they can be occluded by a tumor, restricted by plaque, or weakened by an aneurysm. When this occurs, the passageway can be reopened or reinforced, or even replaced, with a medical endoprosthesis. An endoprosthesis is an artificial implant that is typically placed in a passageway or lumen in the body. Many endoprostheses are tubular members, examples of which include stents, stent-grafts, and covered stents.

Many endoprostheses can be delivered inside the body by a catheter. Typically the catheter supports a reduced-size or compacted form of the endoprosthesis as it is transported to a desired site in the body, for example the site of weakening or occlusion in a body lumen. Upon reaching the desired site the endoprosthesis is installed so that it can contact the walls of the lumen. Stent delivery is further discussed in Heath, U.S. Pat. No. 6,290,721, the entire disclosure of which is hereby incorporated by reference herein.

The expansion mechanism may include forcing the endoprosthesis to expand radially. For example, the expansion mechanism can include the catheter carrying a balloon, which carries a balloon-expandable endoprosthesis. The balloon can be inflated to deform and to fix the expanded endoprosthesis at a predetermined position in contact with the lumen wall. The balloon can then be deflated, and the catheter withdrawn from the lumen.

SUMMARY

In an aspect, the invention features a method of forming an endoprosthesis that includes providing in a deposition chamber a substrate having a first surface and a second, opposing surface; providing a first target and a second target, in the chamber; depositing material from the first target onto the first surface and material from the second target onto the second surface without removing the substrate from the chamber, and utilizing the substrate in an endoprosthesis.

In an aspect, the invention features a system for forming an endoprosthesis that includes a tubular stent or pre-stent substrate, a deposition chamber having a first metal or ceramic target concentrically arranged about a second metal or ceramic target, where the second target is positioned within the tubular stent or pre-stent substrate, and the first target is positioned outside the tubular stent or pre-stent substrate.

In an aspect, the invention features that in the manufacture of a stent, a tubular substrate having simultaneously within its lumen a first plasma for depositing a first ceramic and extension to the tubular a second plasma for depositing a second ceramic having a different composition or morphology than the first ceramic.

Embodiments may include one or more of the following features. The substrate can be tubular, the first surface can be the abluminal surface, and the second surface can be the luminal surface. The second target can be in the lumen of the tubular substrate and the first target can be outside the lumen of the tubular substrate. The deposition can be physical vapor deposition. The power on the substrate and the first target can be controlled. The deposition can be done simultaneously to the first surface and the second surface. Ceramic coatings can be formed by deposition on the first surface and the second surface. The ceramics deposited on the first surface and the second surface can have different morphologies. The first coating can have a defined grain morphology. The second coating can have a globular morphology. The ceramic can be selected from oxides and nitrides of iridium, zirconium, titanium, hafnium, niobium, tantalum, ruthenium, platinum and aluminum. The ceramic can be iridium oxide. The first target can have a different composition than the second target. The second target can have different compositions in different regions. The second target can extend along the axis of the lumen and the different regions can be at different axial locations. The second target can extend along the axis of the lumen and the second target can have a variable shape along its axial extension. The second target can be wider near the end regions of the tubular substrate. An endoprosthesis can be made by the method of providing in a deposition chamber a substrate having a first surface and a second, opposing surface; providing a first target and a second target, in the chamber; depositing material from the first target onto the first surface and material from the second target onto the second surface without removing the substrate from the chamber, and utilizing the substrate in an endoprosthesis.

Embodiments may include one or more of the following features. The first, second and third power can supply connections respectively to the first target, second target and stent or pre-stent substrate. The first target can have a different composition than the second target. The second target can have different compositions in different regions. The second target can extend along the axis of the lumen, and the second target can have a variable shape along its axial extension.

Embodiments may include one or more of the following advantages. Stents can be formed with ceramic coatings that have morphologies and/or compositions that enhance therapeutic performance. In particular, the ceramics are tuned to enhance mechanical performance and physiologic effect. Enhanced mechanical performance provides particular advantages during the challenging operations encountered in stent use, which typically includes collapsing the stent to a small diameter for insertion into the body, delivery though a tortuous lumen, and then expansion at a treatment site. Enhancing mechanical properties of the ceramic reduces the likelihood of cracking or flaking of the ceramic, and enhanced adhesion of the ceramic to the stent body and to overcoatings, such as drug eluting materials. Improved physiologic effects include discouraging restenosis and encouraging endothelialization. The ceramics are tuned by controlling ceramic morphology and composition. For example, the ceramic can have a morphology that enhances endothelial growth, a morphology that enhances the adhesion of overcoatings such as polymers, e.g. drug eluting coatings, a morphology that reduces delamination, cracking or peeling, and/or a morphology that enhances catalytic activity to reduce inflammation, proliferation and restenosis. The ceramic coatings can be tuned along a continuum of their physical characteristics, chemistries, and roughness parameters to optimize function for a particular application. Different coating morphologies can be applied in different locations to enhance different functions at different locations. For example, a high roughness, low coverage, defined-grain morphology can be provided on abluminal surfaces to enhance adhesion of a drug-eluting polymer coating and a low roughness, high coverage, globular morphology can be provided on the luminal surface to enhance endothelialization. The composition is tuned to control hydrophobicity to enhance adhesion to a stent body or a polymer and/or control catalytic effects. The morphologies and composition can be formed by physical vapor deposition using methodologies that allow fine tuning of the morphology characteristics and permit highly uniform, predictable coatings across a desired region of the stent. Further, the two morphologies can be provided to different locations simultaneously or sequentially without taking the stent out of the deposition system, therefore, potential contamination due to vacuum breakdown and long operation time can be reduced or avoided.

Still further aspects, features, embodiments, and advantages follow.

DESCRIPTION OF DRAWINGS

FIGS. 1A-1C are longitudinal cross-sectional views illustrating delivery of a stent in a collapsed state, expansion of the stent, and deployment of the stent.

FIG. 2 is a perspective view of a stent.

FIG. 3 is a cross-sectional view of a stent wall.

FIGS. 4A-4B are enlarged plan views of surface morphologies.

FIGS. 5A-5C are schematic views of ceramic morphologies.

FIG. 6 is a schematic of an inverted cylindrical magnetron deposition system.

FIG. 7 is a schematic of a modified inverted cylindrical magnetron deposition system.

FIGS. 8A and 8B are schematic views of a sputter target.

DETAILED DESCRIPTION

Referring to FIGS. 1A-1C, a stent 20 is placed over a balloon 12 carried near a distal end of a catheter 14, and is directed through the lumen 16 (FIG. 1A) until the portion carrying the balloon and stent reaches the region of an occlusion 18. The stent 20 is then radially expanded by inflating the balloon 12 and compressed against the vessel wall with the result that occlusion 18 is compressed, and the vessel wall surrounding it undergoes a radial expansion (FIG. 1B). The pressure is then released from the balloon and the catheter is withdrawn from the vessel (FIG. 1C).

Referring to FIG. 2, the stent 20 includes a plurality of fenestrations 22 defined in a wall 23. Stent 20 includes several surface regions, including an outer, or abluminal, surface 24, an inner, luminal, surface 26, and a plurality of cut-face surfaces 28. The stent can be balloon expandable, as illustrated above, or self-expanding stent. Examples of stents are further described in Heath '721, supra.

Referring to FIG. 3, a greatly enlarged axial cross-sectional view, a stent wall 23 includes a stent body 25 formed, e.g. of a metal, and includes a first ceramic coating 32 on one side, e.g. the abluminal side 24, and a second ceramic coating 34 on the other side, e.g. the luminal side 26. As illustrated, the coatings 32, 34 have different morphologies and roughnesses. The thickness of each coating, 32 or 34 is represented as T₃₂ or T₃₄, respectively.

Referring as well to FIG. 4A, the coating 32 on the abluminal side includes a morphology characterized by defined grains and high roughness. The defined grain, high roughness morphology of the coating 32 provides a high surface area characterized by crevices between and around spaced grains into which, e.g., a polymer coating can be deposited and interlock to the surface, enhancing adhesion.

Referring as well to FIG. 4B, the coating 34 on the luminal side has a morphology characterized by a higher coverage, globular surface of generally lower roughness. The smoother globular morphology provides a surface tuned to facilitate endothelial growth by selection of its chemical composition and/or morphological features.

The morphology and composition of the ceramic is selected for its mechanical characteristics, to enhance adhesion to the stent body and enhance adhesion of a polymer coating, for example, and/or to enhance therapeutic function such as reducing restenosis and enhancing endothelialization. Certain ceramics, e.g. oxides, can reduce restenosis through the catalytic reduction of hydrogen peroxide and other precursors to smooth muscle cell proliferation. The oxides can also encourage endothelial growth to enhance endothelialization of the stent. When a stent is introduced into a biological environment (e.g., in vivo), one of the initial responses of the human body to the implantation of a stent, particularly into the blood vessels, is the activation of leukocytes, white blood cells which are one of the constituent elements of the circulating blood system. This activation causes a release of reactive oxygen compound production. One of the species released in this process is hydrogen peroxide, H₂O₂, which is released by neutrophil granulocytes, which constitute one of the many types of leukocytes. The presence of H₂O₂ may increase proliferation of smooth muscle cells and compromise endothelial cell function, stimulating the expression of surface binding proteins which enhance the attachment of more inflammatory cells. A ceramic such as iridium oxide (IROX) can catalytically reduce H₂O₂. The morphology of the ceramic can enhance the catalytic effect and reduce growth of smooth muscle cells. Iridium oxide (IROX) is discussed further in Alt, U.S. Pat. No. 5,980,566. Defined grain morphologies may also allow for greater freedom of motion and are less likely to fracture as the stent is flexed in use and thus the coating resists delamination of the ceramic from an underlying surface and reduces delamination of an overlaying polymer coating. The stresses caused by flexure of the stent, during expansion or contraction of the stent or as the stent is delivered through a tortuously curved body lumen increase as a function of the distance from the stent axis. As a result, in embodiments, a morphology with defined grains is particularly desirable on abluminal regions of the stent or at other high stress points, such as the regions adjacent fenestrations which undergo greater flexure during expansion or contraction.

The morphology of the surface of the ceramic is characterized by its visual appearance, the size and arrangement of particular morphological features such as local maxima, and/or its roughness. In embodiments, the surface is characterized by definable sub-micron sized grains. Referring particularly to FIG. 4A, for example, in embodiments, the grains have a length, L, of about 50 to about 500 nm, e.g. about 100-300 nm, and a width, W, of about 5 nm to 50 nm, e.g. about 10-15 nm. The grains have an aspect ratio (length to width) of about 5:1 or more, e.g. 10:1 to 20:1. The grains overlap in one or more layers. The separation between grains can be about 1-50 nm. In particular embodiments, the grains resemble rice grains.

Referring particularly to FIG. 4B, in embodiments, the surface is characterized by a more continuous surface having a series of shallow globular features. The globular features are closely adjacent with a narrow minimum between features. In embodiments, the surface resembles an orange peel. The diameter of the globular features is about 100 nm or less, and the depth of the minima, or the height of the maxima of the globular function is e.g. about 50 nm or less, e.g. about 20 nm or less.

Referring to FIGS. 5A-5C, morphologies are also characterized by the size and arrangement of morphological features such as the spacing, height and width of local morphological maxima. Referring particularly to FIG. 5A, a coating 40 on a substrate 42 is characterized by the center-to-center distance and/or height, and/or diameter and/or density of local maxima. In particular embodiments, the average height, distance and diameter are in the range of about 400 nm or less, e.g. about 20-200 nm. In particular, the average center-to-center distance is about 0.5 to 2× the diameter.

Referring to FIG. 5B, in particular embodiments, the morphology type is a globular morphology, the width of local maxima is in the range of about 100 nm or less and the peak height is about 20 nm or less. In particular embodiments, the ceramic has a peak height of less than about 5 nm, e.g., about 1-5 nm, and/or a peak distance less than about 15 nm, e.g., about 10-15 nm. Referring to FIG. 5C, in embodiments, the morphology is defined as a grain type morphology. The width of local maxima is about 400 nm or less, e.g. about 100-400 nm, and the height of local maxima is about 400 nm or less, e.g. about 100-400 nm. As illustrated in FIGS. 5B and 5C, the select morphologies of the ceramic can be formed on a thin layer of substantially uniform, generally amorphous IROX, which is in turn formed on a layer of iridium metal, which is in turn deposited on a metal substrate, such as titanium or stainless steel. The spacing, height and width parameters can be calculated from AFM data. A suitable computational technique is provided below.

The roughness of the surface is characterized by the average roughness, Sa, the root mean square roughness, Sq, and/or the developed interfacial area ratio, Sdr. The Sa and Sq parameters represent an overall measure of the texture of the surface. Sa and Sq are relatively insensitive in differentiating peaks, valleys and the spacing of the various texture features. Surfaces with different visual morphologies can have similar Sa and Sq values. For a surface type, the Sa and Sq parameters indicate significant deviations in the texture characteristics. Sdr is expressed as the percentage of additional surface area contributed by the texture as compared to an ideal plane the size of the measurement region. Sdr further differentiates surfaces of similar amplitudes and average roughness. Typically Sdr will increase with the spatial intricacy of the texture whether or not Sa changes.

In embodiments, the ceramic has a defined grain type morphology. The Sdr is about 100 or more, e.g. about 120 to 200. In addition or in the alternative, the morphology has an Sq of about 20 or more, e.g. about 20 to 30. In particular embodiments, the ceramic has an Sdr of 150 or more, e.g., 180-300. In other embodiments, the ceramic has a globular type surface morphology. The Sdr is about 10 or less, e.g. about 1 to 8. The Sq is about 10 or less, e.g. about less than 3 or 1 to 5. In still other embodiments, the ceramic has a morphology between the defined grain and the globular surface, and Sdr and Sq values between the ranges above, e.g. an Sdr of about 1 to 200 and/or an Sq of about 1 to 30. The Sa, Sq, and Sdr can be calculated from AFM data. A suitable computation scheme is provided below.

The morphology of the ceramic coating can exhibit high uniformity. The uniformity provides predictable, tuned therapeutic and mechanical performance of the ceramic. The uniformity of the morphology as characterized by Sa, Sq or Sdr and/or average peak spacing parameters can be within about +/−20% or less, e.g. +/−10% or less within a 1 μm square. In a given stent region, the uniformity is within about +/−10%, e.g. about +/−1%. For example, in embodiments, the ceramic exhibits high uniformity over an entire surface region of stent, such as the entire abluminal or luminal surface, or a portion of a surface region, such as the center 25% or 50% of the surface region. The uniformity is expressed as standard deviation. Uniformity in a region of a stent can be determined by determining the average in five randomly chosen 1 μm square regions and calculating the standard deviation. Uniformity of visual morphology type in a region is determined by inspection of FESEM data at 50 KX.

The ceramics are also characterized by surface composition, composition as a function of depth, and crystallinity. In particular, the amounts of oxygen or nitride in the ceramic is selected for a desired catalytic effect on, e.g., the reduction of H₂O₂ in biological processes. The composition of metal oxide or nitride ceramics can be determined as a ratio of the oxide or nitride to the base metal. In particular embodiments, the ratio is about 2 to 1 or greater, e.g. about 3 to 1 or greater, indicating high oxygen content of the surface. In other embodiments, the ratio is about 1 to 1 or less, e.g. about 1 to 2 or less, indicating a relatively low oxygen composition. In particular embodiments, low oxygen content globular morphologies are formed to enhance endothelialization. In other embodiments, high oxygen content defined grain morphologies are formed, e.g., to enhance adhesion and catalytic reduction. Composition can be determined by x-ray photoelectron spectroscopy (XPS). Depth studies are conducted by XPS after argon sputtering. The crystalline nature of the ceramic can be characterized by crystal shapes as viewed in FESEM images, or Miller indices as determined by x-ray diffraction. In embodiments, defined grain morphologies have a Miller index of <101>. Globular materials have blended amorphous and crystalline phases that vary with oxygen content. Higher oxygen content typically indicates greater crystallinity.

In some embodiments, a stent with different ceramic coatings (e.g., coatings 32, 34 in FIG. 3 with different morphologies) on different portions of the stent can be formed through sequential steps. For example, in a first step, a stent can be coated on all surfaces with a globular morphology in e.g. an inverted cylindrical physical vapor deposition system, as illustrated in FIG. 6. In a second step, a mandrel is inserted into the stent to mask the luminal surface. In a third step, a defined grain morphology is coated on the abluminal and cutface surfaces over the previously deposited globular morphology. The deposition is usually carried out under vacuum, therefore, between the first and second steps, when the stent is taken out of the deposition system to apply a mask (e.g., a mandrel), the system needs to be brought to normal atmospheric pressure.

Referring to FIG. 6, the coatings can be formed using an inverted cylindrical physical vapor deposition arrangement 50 including a cathode 52 within which resides a target material 54, such as a ceramic (e.g. IROX) or a ceramic precursor metal (e.g. Ir). A stent 56 (or precursor component of a stent) is disposed within the cylinder. The cylinder also includes a gas, such as argon and oxygen. A plasma formed in the cylinder accelerates charged species toward the target. Target material is sputtered from the target and is deposited onto the stent (arrow 58). The sputtered species, e.g., atoms can travel along random directions. Some of the sputtered species strike the stent including all the stent surfaces and form a sputter coating thereon.

The operating parameters of the deposition system are selected to tune the morphology and/or composition of the ceramic. In particular, the power, total pressure, oxygen/argon ratio and sputter time are controlled. By increasing the power and/or total pressure the morphology becomes more defined grain, rougher and crystalline. By decreasing these parameters the coating becomes more globular and less rough. In embodiments, the power is within about 340 to 700 watts, e.g. about 400 to 600 watts and the total pressure is about 10 to 30 mTorr. In other embodiments the power is about 100 to 350 watts, e.g. about 150 to 300 watts, and the total pressure is about 1 to 10 mTorr, e.g. about 2 to 6 mTorr. The oxygen partial pressure is in the range of about 10 to 90%. Particular ranges are about 80-90%, e.g. for defined grain morphologies, and 10 to 40%, e.g. for globular morphologies. The deposition time controls the thickness of the ceramic and the stacking of morphological features. In embodiments, the deposition time is about 0.5 to 10 minutes, e.g. about 1 to 3 minutes. The overall thickness of the ceramic is about 50-500 nm, e.g. about 100 to 300 nm. The oxygen content is increased at higher power, higher total pressure and high oxygen to oxygen ratios.

Inverted cylindrical physical vapor deposition is described further in Siegfried et al., Society of Vacuum Coaters, 39^(th) Annual Technical Conference Proceedings (1996), p. 97; Glocker et al., Society of Vacuum Coaters, 43^(rd) Annual Technical Conference Proceedings-Denver, Apr. 15-20, 2000, p. 81; and SVC: Society of Vacuum Coatings: C-103, An Introduction to Physical Vapor Deposition (PVD) Processes and C-248—Sputter Deposition in Manufacturing, available from SVC 71 Pinion Hill, Nebr., Albequeque, N. Mex. 87122-6726. A suitable cathode system is the Model 514, available from Isoflux, Inc., Rochester, N.Y. Other sputtering techniques include closed loop cathode magnetron sputtering. PVD is also described in co-pending application U.S. Ser. No. 11/752,772, filed May 23, 2007 [Attorney Docket No. 10527-805001]. Pulsed laser deposition is described in co-pending application U.S. Ser. No. 11/752,736, filed May 23, 2007 [Attorney Docket No. 10527-801001]. Formation of IROX is also described in Cho et al., Jpn. J. Appl. Phys. 36(I)3B: 1722-1727 (1997), and Wessling et al., J. Micromech. Microeng. 16:5142-5148 (2006).

In some embodiments, a stent with different ceramic coatings (e.g., coatings 32, 34 in FIG. 3 with different morphologies) on different portions of the stent can be formed simultaneously via PVD. Referring to FIG. 7, an embodiment of a modified inverted cylindrical physical vapor deposition system is shown. System 70 includes a sputter chamber 71, a primary target 78 along the interior wall of the chamber, a connection 82 from a substrate power source to a substrate 72, e.g., a stent or a precursor component of a stent (“pre-stent”) such as a metal tube, a connection 84 from a second power source 84 to a secondary target 76, a magnetron 80, and a third power source (not shown) to power the cylindrical magnetron 80. The secondary target 76 is placed in the lumen of the substrate 72 at a distance from the stent luminal surface and is electrically insulated from the stent by an insulating material 74. The primary target 78 is close to the magnetron 80, which can create a magnetic field adjacent and lying principally parallel to the target and increase deposition rate.

Generally, a first power source, e.g., a negative DC voltage (not shown) is connected or applied to the primary target 78 (as a cathode in this circumstance) of magnitude sufficient to ionize the working gas, e.g., argon, into a plasma, while, e.g., the substrate is connected to an earth ground. The positive argon ions are attracted to the negatively charged target 78 with sufficient energy to sputter atoms of the primary target material, e.g., iridium oxide. The second power source 84 connected to the secondary target 76, e.g., iridium oxide rod, can provide a different potential difference between the target 76 and the substrate 72 (e.g., a stent), compared to the potential difference between the primary target 78 and the stent 72. This arrangement provides different interaction of the plasma gas with the secondary target and different amounts of energy in the luminal and abluminal coating process, therefore codeposition of different morphologies on the luminal and abluminal surfaces of the stent can be realized.

In some embodiments, forming a coating with the defined grain morphology requires higher power or energy then formation of a coating with the globular morphology. Accordingly, for example, the second power source 84 can provide a smaller negative DC voltage than the first power source to reduce the energy of sputtered species from the secondary target 76 as well as the plasma energy interaction with the coating in the process of codepositing the coating with the globular morphology onto the luminal surface and the coating with the defined grain morphology onto the abluminal surface. In some embodiments, when the substrate 72, e.g., a stent or pre-stent is metallic, the stent can function as a faraday cage that can at least partially shield the electromagnetic energy from getting in the stent lumen, and when the energy difference in and out of the stent lumen is sufficient to cause formation of coatings with different morphologies, the second power source 84 may not be necessary. In some embodiments, the energy of the sputtered species in the stent lumen can be reduced by controlling the power settings such that only the abluminal surface of the stent is coated with target material while no coating is formed on the luminal surface. In some embodiments, if forming a coating with the defined grain morphology requires higher power or energy then formation of a coating with the globular morphology, the second power source 84 can provide a larger negative DC voltage and therefore higher energy to the sputtered species.

In some embodiments, to further control the energy of sputtered material, the substrate electrical potential can also be tuned by controlling the energy supplied by the substrate power source 82. For example, a positive voltage can be applied to the substrate, e.g. to increase the potential difference between the substrate and the targets and thus to increase plasma interaction with the target. As another example, a negative voltage can be applied to the substrate e.g. to decrease the energy of the sputtered materials. In yet some embodiments, the secondary target 76 has a different target material than the primary target 78, therefore codeposition of coatings of different composition on different portions of the stent is allowed.

Alternatively or additionally, a stent with different ceramic coatings (e.g., coatings with different morphologies and/or different compositions) on different portions of the stent can also be formed sequentially via PVD using the system illustrated in FIG. 7 without breaking its vacuum. For example, in a first step, the substrate 72, e.g., a stent or pre-stent is coated with materials from the primary target 78 on all its surfaces, or as discussed above, by introducing the second power source 84 to the secondary target 76 and/or through faraday cage effect of a metallic stent, the energy of the sputtered species in the stent lumen can be reduced to a degree such that only the abluminal surface of the stent is coated with material from the primary target 78 while no coating is formed on the luminal surface of the stent. In a second step, enough power is provided to the secondary target 76 via the second power source to coat the luminal and cut-face surfaces, either on top of the coatings formed in the first step or on top of bare stent surfaces. As another example, the luminal surface can be coated with material from the secondary target in a first step, and the abluminal surface can later be coated with material from the primary target in a second step while the luminal surface is shielded from sputtered species by applying a potential to the secondary target.

To further control the compositions and/or morphologies of coatings on the luminal and cut-face surfaces of the stent or pre-stent, the secondary target 76 can be predetermined to have selected composition profile and/or shape. Referring particularly to FIG. 8A, in embodiments, the secondary target can have varying compositions along its longitudinal axis 76 a. The phantom cylinder indicates the relative position of the secondary target inside the substrate 72 (e.g., a stent). For example, the two ends 81 of the secondary target can be an alloy of iridium while the center 83 can be pure iridium. As a result, the luminal surface of the stent can have different compositions along the longitudinal axis of the stent. Referring particularly to FIG. 8B, the secondary target 76 can have a dumbbell shape. The phantom cylinder indicates the relative position of the secondary target inside the substrate 72 (e.g., a stent). As illustrated, the two end regions of the target 76 are at a closer distance from the stent luminal surface than the central region of the target. Without wishing to be bound by theory, it is believed that the speed thus the energy of the sputtered species increases while the distance of the target to the substrate decreases. In particular embodiments, the higher energy leads to defined grain morphology and the low energy leads to globular morphology. As a result, the two terminal regions of the luminal surface can be coated with defined grain morphology while the central region of the luminal surface can be coated with globular morphology. The substrate 72, e.g., a stent or a present, can have some selected regions shielded by a mask before it is positioned in the deposition system in order to have some regions free of ceramic coatings. The substrate may be positioned in the center or an off-center location of the deposition system, e.g., to have a uniform or non-uniform coating on the abluminal surface. In other embodiments, the target 78 can be formed of different material or shape along the axial extension of the substrate to deposit different ceramics on select regions of the abluminal surfaces.

In embodiments, the stent can be formed of metal. Stent metal can be stainless steel, chrome, nickel, cobalt, tantalum, superelastic alloys such as nitinol, cobalt chromium, MP35N, and other metals. Suitable stent materials and stent designs are described in Heath '721, supra. In embodiments, the morphology and composition of the ceramic are selected to enhance adhesion to a particular metal. For example, in embodiments, the ceramic is deposited directly onto the metal surface of a stent body, e.g. a stainless steel, without the presence of an intermediate metal layer. In other embodiments, a layer of metal common to the ceramic is deposited onto the stent body before deposition to the ceramic. For example, a layer of iridium may be deposited onto the stent body, followed by deposition of IROX onto the iridium layer. Other suitable ceramics include metal oxides and nitrides, such as of iridium, zirconium, titanium, hafnium, niobium, tantalum, ruthenium, platinum and aluminum. The ceramic can be crystalline, partly crystalline or amorphous. The ceramic can be formed entirely of inorganic materials or a blend of inorganic and organic material (e.g. a polymer). The target can be formed of the ceramic to be deposited. A metal target (e.g. Ti, Ta, etc.) can also be provided and a ceramic formed through reactive sputtering by introducing e.g., O2 or N2 into the plasma to form a metal oxide or nitride.

In embodiments, a polymer, e.g., a drug eluting polymer, may be applied to the ceramic coatings of the stent. The ceramic can therefore also be selected for compatibility with a particular polymer coating to, e.g. enhance adhesion. For example, for a hydrophilic polymer, the surface chemistry of the ceramic is made more hydrophilic by e.g., increasing the oxygen content, which increases polar oxygen moieties, such as OH groups. Suitable drug eluting polymers may be hydrophilic or hydrophobic, and may be selected, without limitation, from polymers including, for example, polycarboxylic acids, cellulosic polymers, including cellulose acetate and cellulose nitrate, gelatin, polyvinylpyrrolidone, cross-linked polyvinylpyrrolidone, polyanhydrides including maleic anhydride polymers, polyamides, polyvinyl alcohols, copolymers of vinyl monomers such as EVA, polyvinyl ethers, polyvinyl aromatics such as polystyrene and copolymers thereof with other vinyl monomers such as isobutylene, isoprene and butadiene, for example, styrene-isobutylene-styrene (SIBS), styrene-isoprene-styrene (SIS) copolymers, styrene-butadiene-styrene (SBS) copolymers, polyethylene oxides, glycosaminoglycans, polysaccharides, polyesters including polyethylene terephthalate, polyacrylamides, polyethers, polyether sulfone, polycarbonate, polyalkylenes including polypropylene, polyethylene and high molecular weight polyethylene, halogenerated polyalkylenes including polytetrafluoroethylene, natural and synthetic rubbers including polyisoprene, polybutadiene, polyisobutylene and copolymers thereof with other vinyl monomers such as styrene, polyurethanes, polyorthoesters, proteins, polypeptides, silicones, siloxane polymers, polylactic acid, polyglycolic acid, polycaprolactone, polyhydroxybutyrate valerate and blends and copolymers thereof as well as other biodegradable, bioabsorbable and biostable polymers and copolymers. Coatings from polymer dispersions such as polyurethane dispersions (BAYHDROL.®, etc.) and acrylic latex dispersions are also within the scope of the present disclosure. The polymer may be a protein polymer, fibrin, collagen and derivatives thereof, polysaccharides such as celluloses, starches, dextrans, alginates and derivatives of these polysaccharides, an extracellular matrix component, hyaluronic acid, or another biologic agent or a suitable mixture of any of these, for example. In one embodiment, the suitable polymer is polyacrylic acid, available as HYDROPLUS.®. (Boston Scientific Corporation, Natick, Mass.), and described in U.S. Pat. No. 5,091,205, the disclosure of which is hereby incorporated herein by reference. U.S. Pat. No. 5,091,205 describes medical devices coated with one or more polyiocyanates such that the devices become instantly lubricious when exposed to body fluids. Another suitable polymer is a copolymer of polylactic acid and polycaprolactone. Suitable polymers are discussed in U.S. Publication No. 2006/0038027.

The polymer is preferably capable of absorbing a substantial amount of drug solution. When applied as a coating on a medical device in accordance with the present disclosure, the dry polymer is typically on the order of from about 1 to about 50 microns thick. In the case of a balloon catheter, the thickness is preferably about 1 to 10 microns thick, and more preferably about 2 to 5 microns. Very thin polymer coatings, e.g., of about 0.2-0.3 microns and much thicker coatings, e.g., more than 10 microns, are also possible. It is also within the scope of the present disclosure to apply multiple layers of polymer coating onto a medical device. Such multiple layers are of the same or different polymer materials.

The terms “therapeutic agent”, “pharmaceutically active agent”, “pharmaceutically active material”, “pharmaceutically active ingredient”, “drug” and other related terms may be used interchangeably herein and include, but are not limited to, small organic molecules, peptides, oligopeptides, proteins, nucleic acids, oligonucleotides, genetic therapeutic agents, non-genetic therapeutic agents, vectors for delivery of genetic therapeutic agents, cells, and therapeutic agents identified as candidates for vascular treatment regimens, for example, as agents that reduce or inhibit restenosis. By small organic molecule is meant an organic molecule having 50 or fewer carbon atoms, and fewer than 100 non-hydrogen atoms in total.

Exemplary therapeutic agents include, e.g., anti-thrombogenic agents (e.g., heparin); anti-proliferative/anti-mitotic agents (e.g., paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine, inhibitors of smooth muscle cell proliferation (e.g., monoclonal antibodies), and thymidine kinase inhibitors); antioxidants; anti-inflammatory agents (e.g., dexamethasone, prednisolone, corticosterone); anesthetic agents (e.g., lidocaine, bupivacaine and ropivacaine); anti-coagulants; antibiotics (e.g., erythromycin, triclosan, cephalosporins, and aminoglycosides); agents that stimulate endothelial cell growth and/or attachment. Therapeutic agents can be nonionic, or they can be anionic and/or cationic in nature. Therapeutic agents can be used singularly, or in combination. Preferred therapeutic agents include inhibitors of restenosis (e.g., paclitaxel), anti-proliferative agents (e.g., cisplatin), and antibiotics (e.g., erythromycin). Additional examples of therapeutic agents are described in U.S. Published Patent Application No. 2005/0216074. Polymers for drug elution coatings are also disclosed in U.S. Published Patent Application No. 2005/019265A.

Any stent described herein can be dyed or rendered radiopaque by addition of, e.g., radiopaque materials such as barium sulfate, platinum or gold, or by coating with a radiopaque material. The stent can include (e.g., be manufactured from) metallic materials, such as stainless steel (e.g., 316L, BioDur® 108 (UNS S29108), and 304L stainless steel, and an alloy including stainless steel and 5-60% by weight of one or more radiopaque elements (e.g., Pt, Ir, Au, W) (PERSS®) as described in US-2003-0018380-A1, US-2002-0144757-A1, and US-2003-0077200-A1), Nitinol (a nickel-titanium alloy), cobalt alloys such as Elgiloy, L605 alloys, MP35N, titanium, titanium alloys (e.g., Ti-6A1-4V, Ti-50Ta, Ti-10Ir), platinum, platinum alloys, niobium, niobium alloys (e.g., Nb-1Zr) Co-28Cr-6Mo, tantalum, and tantalum alloys. Other examples of materials are described in commonly assigned U.S. application Ser. No. 10/672,891, filed Sep. 26, 2003; and U.S. application Ser. No. 11/035,316, filed Jan. 3, 2005. Other materials include elastic biocompatible metal such as a superelastic or pseudo-elastic metal alloy, as described, for example, in Schetsky, L. McDonald, “Shape Memory Alloys”, Encyclopedia of Chemical Technology (3rd ed.), John Wiley & Sons, 1982, vol. 20. pp. 726-736; and commonly assigned U.S. application Ser. No. 10/346,487, filed Jan. 17, 2003.

The stents described herein can be configured for vascular, e.g. coronary and peripheral vasculature or non-vascular lumens. For example, they can be configured for use in the esophagus or the prostate. Other lumens include biliary lumens, hepatic lumens, pancreatic lumens, and urethral lumens.

The stent can be of a desired shape and size (e.g., coronary stents, aortic stents, peripheral vascular stents, gastrointestinal stents, urology stents, tracheal/bronchial stents, and neurology stents). Depending on the application, the stent can have a diameter of between, e.g., about 1 mm to about 46 mm. In certain embodiments, a coronary stent can have an expanded diameter of from about 2 mm to about 6 mm. In some embodiments, a peripheral stent can have an expanded diameter of from about 4 mm to about 24 mm. In certain embodiments, a gastrointestinal and/or urology stent can have an expanded diameter of from about 6 mm to about 30 mm. In some embodiments, a neurology stent can have an expanded diameter of from about 1 mm to about 12 mm. An abdominal aortic aneurysm (AAA) stent and a thoracic aortic aneurysm (TAA) stent can have a diameter from about 20 mm to about 46 mm. The stent can be balloon-expandable, self-expandable, or a combination of both (e.g., Heath, U.S. Pat. No. 6,290,721). The ceramics can be used with other endoprostheses or medical devices, such as catheters, guide wires, and filters.

In embodiments, the drug-eluting polymer layer are provided only on the ceramic coating of the stent abluminal surface. In other embodiments, the polymer layer is provided as well or only on the ceramic coatings of luminal surface and/or cut-face surfaces.

All publications, patent applications, patents, and other references mentioned herein are incorporated by reference herein in their entirety.

Still further embodiments are in the following claims. 

1. A method of forming an endoprosthesis, comprising: providing in a deposition chamber a substrate having a first surface and a second, opposing surface; providing a first target and a second target, in the chamber; depositing material from the first target onto the first surface and material from the second target onto the second surface without removing the substrate from the chamber, and utilizing the substrate in an endoprosthesis.
 2. The method of claim 1 wherein the substrate is tubular and the first surface is the abluminal surface and the second surface is the luminal surface.
 3. The method of claim 2 wherein the second target is in the lumen of the tubular substrate and the first target is outside the lumen of the tubular substrate.
 4. The method of claim 3 comprising depositing by physical vapor deposition.
 5. The method of claim 4 comprising controlling the power on the substrate and first target.
 6. The method of claim 5 comprising simultaneously depositing onto the first surface and the second surface.
 7. The method of claim 5 or 6 comprising depositing to form ceramic coatings on the first surface and the second surface.
 8. The method of claim 7 comprising depositing ceramics on the first surface and the second surface having different morphologies
 9. The method of claim 8 wherein the first coating has a defined grain morphology.
 10. The method of claim 9 wherein the second coating has a globular morphology.
 11. The method of claim 10 wherein the ceramic is selected from oxides and nitrides of iridium, zirconium, titanium, hafnium, niobium, tantalum, ruthenium, platinum and aluminum.
 12. The method of claim 11 wherein the ceramic is iridium oxide.
 13. The method of claim 3 wherein the first target has a different composition than the second target.
 14. The method of claim 3 wherein the second target has different compositions in different regions.
 15. The method of claim 14 wherein the second target extends along the axis of the lumen and the different regions are at different axial locations.
 16. The method of claim 3 wherein the second target extends along the axis of the lumen, and the second target has a variable shape along its axial extension.
 17. The method of claim 16 wherein the second target is wider near the end regions of the tubular substrate.
 18. An endoprosthesis made by the method of claim
 1. 19. A system for forming an endoprosthesis, comprising: a tubular stent or pre-stent substrate, a deposition chamber having a first metal or ceramic target concentrically arranged about a second metal or ceramic target, the second target positioned within the tubular stent or pre-stent substrate, and the first target positioned outside the tubular stent or pre-stent substrate.
 20. The system of claim 19 including first, second and third power supply connections respectively to the first target, second target and stent or pre-stent substrate.
 21. The system of claim 19 wherein the first target has a different composition than the second target.
 22. The system of claim 19 wherein the second target has different compositions in different regions.
 23. The system of claim 19 wherein the second target extends along the axis of the lumen, and the second target has a variable shape along its axial extension.
 24. In the manufacture of a stent, a tubular substrate having simultaneously within its lumen a first plasma for depositing a first ceramic and extension to the tubular a second plasma for depositing a second ceramic having a different composition or morphology than the first ceramic.
 25. The system of claim 24 wherein the first and/or second plasma deposits a third ceramic of a select axial location along the tubular substrate, the third ceramic being of a different composition or morphology than the first or second ceramic, respectively, or different than the first and second ceramic. 